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Lord, Lynne Marie 4464, NEW YORK STATE DEPARTMENT OF HEALTH urial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Lynne Marie Lord Female Date of Death Age If Veteran of U.S.Armed Forces, 02/06/2024 79 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital • Manner of Death Natural Cause EAccident �Homicide ESuicide FlUndetermined ElPending Circumstances Investigation W• Medical Certifier Name Title 0 Marcille Labban MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 77 Burial Date Cemetery,Crematory or Facility Name '11111M 02/08/2024 Pine View Crematory _Entombment Address ©Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed and/or and/or Held F Hold Address 0 Q. Date Point of U)OTransportation p by Common Shipment Carrier Destination EIDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward, New York 12828 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above Address CC W 0- Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/08/2024 Registrar of Vital Statistics Megan Wolin(ECectronicaCCySigned) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition ....,,07v,7yPlace of Disposition /�, ,J e t. e„J Cf -f" 2 (address) J W N (section) (lot umber) (grave number) • Name of Sexton or Person in Charge of Pr ices (please print) W Signature f /-/ Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) ' " Receipt 1 Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#